{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:46:43Z","timestamp":1791578803980,"version":"4.3.4"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Integrating smoking cessation interventions within lung cancer screening (LCS) programs may significantly reduce smoking-related morbidity and mortality. Data on costs and cost-effectiveness of smoking cessation interventions in the context of LCS can foster the dissemination of effective treatments.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the cost-effectiveness from a health system perspective of 8 smoking cessation treatment strategies evaluated in the context of the Screen Aiding Screening Support In Stopping Tobacco (ASSIST) trial among patients undergoing LCS in 1 large health care system.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n The Screen ASSIST trial used a 3-way factorial design testing the effectiveness of 8 combinations of smoking cessation treatments at a health system in Massachusetts with 11 participating LCS sites. In this economic evaluation, costs and cost-effectiveness were evaluated prospectively and contextualized through sensitivity analyses. Participants included English-speaking and Spanish-speaking patients who smoked and were scheduled for LCS between April 2019 and July 2023.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomized to 4 vs 8 counseling sessions, 2 vs 8 weeks of nicotine replacement therapy (NRT), and screening for social determinants of health (SDH) vs no screening.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary effectiveness outcome was self-reported 7-day smoking abstinence at 6 months. Cost measures included both start-up and operating costs, with incremental cost per quit (ICQ) calculated relative to usual care.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Screen ASSIST had 642 participants (mean [SD] age, 64.0 [6.5] years; 358 female [55.8%]; mean [SD] 36.8 [19.4] pack-years; mean [SD] 16.2 [8.2] cigarettes per day). Start-up costs for the program were $131\u202f371, primarily for electronic health record programming ($124\u202f903). Operating costs for the intervention conditions ranged from $196\u202f272 to $274\u202f865 for 642 participants. The ICQ of 8 counseling sessions, 2 weeks NRT, and no SDH screening was $3050 (95% CI, $1286-4815), the most cost-effective condition. Per-patient costs and ICQ would be lower in health systems serving larger patient populations.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this economic evaluation of smoking cessation treatment in LCS, 8-session counseling combined with 2 weeks of NRT was a cost-effective strategy, with a favorable ICQ relative to usual care and other treatment strategies evaluated. These findings are relevant for health systems considering integrating smoking cessation programs with LCS services.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.55332","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T16:30:38Z","timestamp":1769185838000},"page":"e2555332","source":"Crossref","is-referenced-by-count":3,"title":["Economic Evaluation of Tobacco Treatments From the Screen ASSIST Lung Cancer Screening Trial"],"prefix":"10.1001","volume":"9","author":[{"given":"Douglas E.","family":"Levy","sequence":"first","affiliation":[{"name":"Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston"},{"name":"Tobacco Research and Treatment Center, Division of General Internal Medicine, Massachusetts General Hospital, Boston"},{"name":"Harvard Medical School, Boston, 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